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Clinical Practice Trends and Postoperative Outcomes in Primary Cleft Rhinoplasty
Hossein E Jazayeri1, Joseph Lopez2, Navid Pourtaheri3
121614Michigan Medicine, Ann Arbor, MI, USA.
Insights
Primary cleft rhinoplasty is increasingly common for infants, showing shorter hospital stays without increased costs or complications. This suggests considering rhinoplasty during initial cleft lip repair planning.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Cleft nasal deformity correction is complex.
- Surgical approaches vary for primary cleft lip repair.
Purpose of the Study:
- To compare practice patterns and outcomes of primary cleft lip repair with and without concurrent rhinoplasty.
- To analyze trends in simultaneous cleft lip repair and rhinoplasty.
Main Methods:
- Retrospective cohort study using the Kids' Inpatient Database (2000-2011).
- Inclusion of infants (≤12 months) undergoing cleft lip repair.
- Analysis of hospital setting, cost, length of stay, and complication rates.
Main Results:
- Over 31% of infants underwent primary cleft rhinoplasty.
- A significant increase in simultaneous cleft lip repair and rhinoplasty was observed over time.
- Patients receiving primary rhinoplasty had a shorter length of stay (1.6 vs. 2.8 days).
Conclusions:
- Primary cleft rhinoplasty is a growing trend in surgical practice.
- Simultaneous rhinoplasty during cleft lip repair is associated with improved efficiency (shorter hospital stay).
- Rhinoplasty should be considered in the surgical planning for cleft nasal deformities.
Purpose:
Optimal correction of the cleft nasal deformity remains challenging. The purpose of this study was to examine the practice patterns and postoperative course of patients undergoing cleft lip repair with rhinoplasty compared to those who have primary lip repair without rhinoplasty.
Methods And Materials:
A retrospective cohort study was conducted based on the Kids' Inpatient Database. Data were collected from January 2000 to December 2011 and included infants aged 12 months and younger who underwent cleft lip repair. The predictor variable was the addition of rhinoplasty at primary cleft lip repair. Primary outcome variables included hospital setting, year, and admission cost, while secondary outcome variables included length of stay and postoperative complication rate. Independent t-tests and chi-squared tests were performed. Continuous variables were analyzed by multiple linear regression models.
Results:
The study sample included 4559 infants with 1422 (31.2%) who underwent primary cleft rhinoplasty. Over time, there was a significant increase in the proportion of cleft lip repairs accompanied by a rhinoplasty (p < .01). A greater proportion of patients with unilateral cleft lips received simultaneous rhinoplasty with their lip repairs (33.8 vs 26.0%, p < .01). This cohort had a significantly shorter length of stay (1.6 vs 2.8 days, p < .01) when compared to children that underwent cleft lip repair alone.
Conclusions:
Performing primary cleft rhinoplasty is becoming more common among cleft surgeons. Considering comparable costs and complication rates, a rhinoplasty should be considered during the surgical treatment planning of patients with cleft nasal deformities.
